Grum, Kim Marie

Grum, Kim Marie is an sole proprietor health care provider with primary practice located at 2512 Golden Sands Dr , Las Vegas NV 89128-6801. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Grum, Kim Marie can be contacted via phone (215) 919-1558.

Contact Information

Primary practice address
2512 Golden Sands Dr Las Vegas NV 89128-6801
Phone: (215) 919-1558
Fax: (215) 491-1750
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 13939693 Utah

Profile Details

NPI number 1649271933
LBN Legal business name Grum, Kim Marie
Credentials LSUDC, CAADC, CRS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 9th, 2005
Last updated May 20th, 2024 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649271933 NPPES
Pennsylvania Other 0284366000 INDEPENDENCE BLUE CROSS
Pennsylvania MEDICAID 07802520 INDEPENDENCE BLUE CROSS
Pennsylvania MEDICAID 1649271933 INDEPENDENCE BLUE CROSS
Pennsylvania Other 447982 INDEPENDENCE BLUE CROSS
Pennsylvania Other 1015164 INDEPENDENCE BLUE CROSS

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